Payment Status Check
This form is to allow you to check the status of any payment you have not received (30 days) from the date your Affidavit was APPROVED.
We ask that you "not list" any job number that was mailed to us (35 days) or less (must allow mail time), please allow 3-5 days for a response by email, phone or fax.
Do not submit duplicate Job Numbers or REPEAT payment forms, this will cause a delay in our research and wasted time and is unnecessary.
Process Server Name:
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Today's Date:
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Field Sheet Number (1):
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Field Sheet Number (2):
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Type N/A in this field if you do not have another Field Sheet to enter.
Field Sheet Number (3):
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Type N/A in this field if you do not have another Field Sheet to enter.
Field Sheet Number (4):
Type N/A in this field if you do not have another Field Sheet to enter.
Field Sheet Number (5):
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Type N/A in this field if you do not have another Field Sheet to enter.
Field Sheet Number (6):
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Type N/A in this field if you do not have another Field Sheet to enter.
Did you mail the "Original Affidavit" to our office at least (35) days ago?
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Select Option Below
Yes, all originals have been mailed at least (35) days
No, some of these were mailed less then (35) days
There are many cases where the original could have been lost in the mail or we receive incomplete Affidavits (not signed, completed or notarized).
We cannot research payment for jobs that we have not yet received the original Affidavit for because we process payments upon receipt and "approval" of the original Affidavit.
If you did not mail the original Affidavit at least (35) days ago, you should not report the job numbers on this form.
Email Address (for confirmation):
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Type your email address in this field for an automated confirmation and copy of this form.